GeneralNorwood

5 hours ago, jjalay said:

Your donor has already signs of depletion. Where are you going to find these 5k grafts?

I leave it to surgeon. But i can say that there are areas with native density that weren't use during my first surgery. 

2 hours ago, asterix0 said:

@GeneralNorwood Do you plan to just focus on the paretial areas to blend your sides and the top more naturally, and add more density in the midscalp? Medication will hopefully hold your crown area and back so it doesn't dip more, are you on finasteride or dutasteride?

 

For sure bringing back naturalness and repairing this "disconnection" is my top priority. There will be more focus on midscalp then on the crown i think. I use finasteride 6 times per week and dutasteride once a week. 

2 hours ago, Berba11 said:

The man has had multi in-person consultations with some of the very best in the business, which suggests the number 5K hasn't just been plucked out of thin air, don't ya think?

Yeah, this is number that actually was suggested by 2 surgeons and both said that this is under depletion level. So after i use 5k graft, i could still wear longer hair  in the donor.

On 3/26/2024 at 10:14 AM, Bandit90 said:

Just looking at your recent update. It’s surreal because you have the same progression of hair loss as I did. Similar to yours mine just seemed to thin out, wish I kept some old photos to show. It’s the first time I’ve seen another user have this pattern on HRN. Also looks like we have a very similar final hair loss pattern and hair characteristics too. I know you’ve mentioned previously that you’re not the biggest advocate of beard hair on the scalp, but I feel they could do a lot of mileage in that mid-scalp area when intelligently blended (I struggle to distinguish between scalp and beard in my midscalp), freeing up those precious scalp grafts for those humps, crown and areas just behind the temples. Fortunately, with your head shape, I don’t think you have a huge crown area to cover so this should help make those scalp grafts go further. Appreciate, that it has been a stressful couple of years for you since your first surgery and has not been the outcome that you hoped for, but genuinely wish you the best outcome in your next procedure, it's clear that you are making all the right moves within your consults.

Yeah, that is true. Our final patterns are the same, we are both Norwood 7 with blonde hair. However 3 years ago i decided to start medical therapy and therefore i am keeping alive "leftovers" that survived DHT massacre. 

This is the photo that i took 3 years ago, when i decided to shave it off and start medical therapy. The norwood 7 pattern is obvious. 

Anyway for now the plan is to take ~5 k scalp grafts from the donor. Three surgeons told me that my beard characteristics are different compared to hair and it is not good idea to use them. 

I think that 5k hair transplant combined with vellus hair that i still have, will do the job. But when i lose my vellus hair, even with medication that i am taking, then it will be problematic. 

On 3/26/2024 at 9:34 AM, bigmistake said:

@GeneralNorwood if you will shave your head, then can you please share pictures of donor scars from your FUE surgery. Both in the sides above the ears and in the donor

I think that scars are pretty visible at pictures from the recent update. I can post some more, but currently i don't have photos with short hair from the back. 

For me the scars are to big in terms of what can be achieved nowadays. 

Is doing FUE before FUT would yield same number of grafts than FUT before FUE? Does it matter which procedure we do first? (besides money)

So for example : 

1. We are doing FUE from 50cm2 area and we reduce density of this area from 90 grafts/cm2 to 70 grafts/cm2. Then we take a strip from same area, so we take strip from 50cm2 area with 70 grafts/cm2. 

2. We are just doing strip from virgin 50cm2 area with 90 grafts/cm2

Nearly 2 months passed since last update and i see some benefit of using minoxidil twice a day and weekly microneedling on the bald scalp. However nothing magical happened of course, miniaturised hair are miniaturised hair, they have their limits. 

I didn't shave top since 3 months, so you can get the idea how weak miniaturised hair are.

I was only shaving sides and back of the head and transplanted hair, so generally i was shaving stronger hair which are growing so much faster then miniaturised hair. However i didn't shave "stronger hair" since few weeks.

The disconnection is the worst, that's my priority to fix : 

Here disconnection maybe looks smaller, but it is still there : 

And super bend backwards: 

I didn't shave donor recently, because i am preapering for the next consultation. I hope it will be the last one!

If you're sticking with Eugenix, maybe at least write them to have Sethi in the planning of the procedure. After all, you are a regular customer.

On 3/8/2024 at 12:09 AM, shiba1985 said:

 

In my opinion Zarev extracts partial grafts and not true follicular units. Meaning if it is a 3 hair follicle he will extract 1 or 2 of the hairs. He makes up for this by transplanting large quantity of follicles. End result is the same. 

JMO. but feel like it is true based on the punch size, but also a repair case where he had to remove the misplaced follicles over multiple sessions. 

Nah, it doesn't make sense to me. He uses punch size from 0,5 mm - 0,8mm. So if there is 3 hair folicle, he propably uses 0,8 mm punch like other surgeons

However when he uses very small punch for the single hair, the problem can occur when there is second hair hidden under the skin(just starts growing). But how often this kind of situation occurs? 

On 3/8/2024 at 2:30 PM, Frosted Flaked said:

 

 

 

 

If this is what you really wanted, then that's it, this is the final result. And yes, it looks better then SMP on bald scalp. 

But in this case, i don't see point in doing next HT, it will only cause more scarring in the donor. 

12 hours ago, Gatsby said:

that's a fair point and one that I myself like to point out that no surgeon/clinic is free from a bad result.

Yeah, but Eugenix had so many bad results. It got to the point that even Melvin emphasized "We don't recommend clinics, we recommend surgeons"

It is really misleading for people that owners of the clinic are recommended, but the rest of the clinic is not. It's as if the boss isn't responsible for the performance of his employees. 

No guys, in real world the boss takes the blame for this employees, because he is running the show. 

1 hour ago, GoliGoliGoli said:

Look up GeneralNorwood and Captain Haddock's cases. There are others too (Including Tommy1991's) but you'll need to look, I don't keep a folder on my computer titled "Sloppy Eugenix Work".

It's always pleasure to be mentioned 😂

My case is mostly reckless/weird planning. Many people won't consider it as botchery, but many surgeons are. 

Planning is one of the most important aspects of HT and can be botched. 

However i saw worse cases from Eugenix then mine or Tommy1991's on this forum. 

1 hour ago, GoliGoliGoli said:

I've been on this forum pretty heavily since I think May 2022. I've never heard the name Dr Vicint.

He propably meant dr. Vinita. 

To be honest, i don't like this idea. I am not a fan of beard grafts at all, but i have to admit that sometimes with right proportions like 80% scalp grafts and 20% beard grafts it can work out. 

However when you transplant 50% and more beard grafts it starts to look unnatural and one of the goals of HT is naturalness. So 100% beard grafts, it is pretty much bird nest on the head and everybody can clap hands and say "wow, it grew so well, bravo!!", but i would rather embrace the baldness and shave completely bald then do such kitschy procedure. 

10 hours ago, Calihome1 said:

Ya, Couto is fantastic.  Probably the best w/ temples, but, I don't want to wait 2-4 years which is why I narrowed it down to Ferreira and Laorwong.

so don't reconstruct temple peaks, that's my advice. 

8 hours ago, jjalay said:

I really dont get this implantation pattern. A whole area on the midscalp was left untouched although he war preety bald in that area. Can you elaborate further on this?

"Just comb it back" Eugenix theory 

Temple points - Couto, Sethi and maybe Zarev (but this is a stretch, because i saw only 1 example,  however very good : https://youtu.be/7xaWGosbBlg?t=1030) 

27 minutes ago, mtb said:

 

 

I see some progress... 

1 hour ago, mtb said:

@GeneralNorwood Something like the tables on the right. If you're thin either from balding or reverse balding (post transplant) these are a doom sentence. These restaurants should have their business licenses revoked. lol 

 

Yes, i agree. Lights between 1000-2000 Kelvins are brutal and should be banned by law 😂

11 hours ago, Berba11 said:

 

From the results we’ve seen, Zittella, Zethi and Zarin all achieve long term results for their patients. 

Yeah, that's right. Team Z for the win 😆

1 hour ago, mtb said:

Also, I get annoyed how every American restaurant, at least in the states I'm in, all have the crazy harsh downlighting. Something about a dark restaurant with a super bright interrogation light bulb overhead makes the frontal hair look thin.

Are you talking about this yellow warm light that looks like first from the left on this picture ? : 

6 hours ago, Bandit90 said:

 

 

 

 

Hi, congratulations on your third HT. 

Can you show pictures with hair from the sides, so we can see how temple points looked before procedure?

4 hours ago, Berba11 said:

Personally I think this would be madness. Better to use available donor resources to improve density behind the hairline (so the weaker parts of the frontal third and going into the midscalp). Your current hairline and temple points look great and will continue to look great in later life. 
 

I wish I’d been more conservative with my own hairline and if I do one day decide to take it back up, it’s costly and multiple surgeries. I honestly think you’d nail this by keeping your hairline exactly as it is and focusing on density. Lower hairlines do not automatically look better just because they’re lower. 

If i could turn back time, i would make my hairline 1 -1.5 cm higher and save at least 1000 grafts, because i need so much grafts on the top for my Norwood 6 pattern. .

About taking it back up. It is not only costly and require multiple surgeries, but when you relocate the grafts the survival rate is only 40-60 %. (see Melvin's podcast with Dr. Bruno Pinto)

1 hour ago, general-etwan said:

Very true. If all eventually goes well with density and I can grow my hair out into a medium length messy fringe type, the precise hairline area can be covered too and it doesn’t need to be super low to look good. 

Yes, that is the goal. Because if you go more aggressive with the hairline you will be stuck with one hairstyle - slickback. 

12 hours ago, general-etwan said:

I have a big and wide foreheard:

 

Your forehead is not so wide like on this pictures. It is a selfie, it makes forehead wider then in reality. 

13 hours ago, general-etwan said:

Yes, absolutely considering SMP as an added tool in addition to a 3rd HT. Question is, should I have SMP done before or after the 3rd HT. That's something I need to research and figure out.

You can consider SMP after all HTs. I had this discussion with my dermatologist. Maybe you won't need SMP. And SMP has some downsides, so it's better to refrain from it, if you want to do next HT. 

On 1/23/2024 at 3:09 AM, general-etwan said:

.

1. I think it may be worth flattening the corners of the hairline just a tiny bit at the front corners. When you see me from the front, the visible upper temple corner recession is very deep, especially with the hair combed back, which means the lateral hump regions are not as strong as they could be. A big reason for the lateral hump areas still looking a little weak is because of the deep upper temple corner recession. The original hairline was a proper start for HT #1, but now spending a few hundred grafts to bring each corner slightly lower may be worth the visual improvement. For example, in Tom Brady, who is rumored to have had hair work over the years (and even if he hasn't, he still serves as a good example of this), the corners of his hairline are flatter, which promotes a slightly more youthful look as opposed to deep temporal recession. I think @Bandit90 also had his hairline slightly "flatter" than mine towards the corners and I'm a big fan of his. I understand this is a risky area to get right but I have confidence we can get it right. It will be a very minor, careful lowering.

 

 

I think it is a bad idea. You have to plan for the next 10-20 years. And besides, your hairline looks fine, i don't see this recession that you are talking about. On this pictures when you drew possible changes, your face is leaned forward, it makes hairline more recessed then in reality. Furthermore, even with face leaned forward, it doesn't look like the hairline needs surgery. 

Let me remind you how they drew the hairline, it was pretty flat : 

If you made it going downwards like this triangle that your drew, fronto temporal angle would be maybe even lower then mid frontal point and  that is a big no-no

Well you can always make photo from the front, so we can see what is exact relation between MFP and FTA. But it has to be made from at least 2m and with straight face to see it exactly how it looks in reality. 

6 hours ago, BeHappy said:

 

The initial consultation was a couple of months before the one year mark after his first HT. He may have looked like he needed closer to 1000 grafts at that time if the hair hadn't fully grown out and matured yet. Once he hit the one year mark and went back, it may have improved enough so that he only needed 300 to 400 grafts.

Honestly though, I'm not sure what BHR could have done. The patient was complaining about a depleted donor, so the Dr shouldn't take hair from the area the patient thinks is already too thin and wants to improve. That only leaves the sides, which in this case was the better hair to take anyway because he was trying to soften the hairline and you need the finer hairs from the sides to properly do that. The patient is complaining that they only took 150 grafts from the sides (100 from one side and 50 from the other), but also complaining that they thinned the area out too much. it would have been much worse if they took more grafts. They did take 150 grafts from (I think it was the beard) to try to do a test to see if those grafts would grow in the back donor area that was depleted from the first HT which was something he wanted to try to improve.

I'm just not sure what else could have been done to try to make this patient happy. He doesn't want to remove grafts, but he wants more grafts. That isn't possible.

 

 

 

Speaking about this 1000 grafts at the initial consultation. I don't think it was Bisanga that estimated this number. I had live consultation with Bisanga and i must say it was most detailed live consultation that i had (from total 4). So i doubt that Bisanga would tell 1000 grafts and then change his mind to 50 grafts few months later. 

I agree that patient concerns about the result are out of place, it is not time yet to write such statements. Bisanga knew what he was doing when he took thinner hair for the hairline. It is "Hair transplants 101". 

i think the whole problem in this situation is that patient regrets that he did this procedure and he feels like he wasted money. And based on this feeling, he has reservations about everything - some of them seem reasonable, others are far-fetched

And why he regrets the procedure? It is a problem of managing the expectations. On the first live consultation somebody in BHR told him that he needs 1000 grafts. Then few months later another person told him online that he needs 300-Then finally at the day of procedure Bisanga told him about low survival rate and that he wants to implant in the hairline only 50 grafts. Patient felt that 50 grafts procedure is a waste of money, so he negotiated and they agreed on  150 grafts in the hairline and 150 extra in the donor. 

I guess, that at the day of operation, it was the first time that Bisanga saw him live. I don't think it is good to make decisions regarding changing plan of the procedure in the heat of the moment and under pressure. 

So to answer your question "what could have been done to make this patient happy?" Managing the patient expectations could be better and plan could be more constant. To provide this the first live consultation should be at least after 12 months mark and should be with the same doctor that is going to lead the surgery. 

I could be wrong about this that first live consultation wasn't with Bisanga(it isn't mentioned in this topic), but it seems really weird to me that Bisanga would say 1000 grafts and then few months later would say "let's do 50 grafts for the test". 

1 hour ago, Odysseus said:

Your opening post said, "He adviced not to implant 300 grafts, but just 50 to see if it will grow. But i still had to pay the full price, so i was like: i am not gonna pay full price for just 50 grafts, so lets do 150 grafts instead. During the surgery the doctor took around 50 grafts from my right side and 100 grafts from the left side."

In your second post you wrote, "Like i said, initial plan was to implant 300, but at surgery date we decided to implant 150."

So you told us that, in exchange for "the full price", you said, "lets do 150 grafts" - and then you confirmed "we decided to implant 150" - and you even describe where the 150 came from. You clearly gave the false impression that you received 150 grafts for "the full price." But the reality was that you got twice as many grafts...a fact that we wouldn't know until BHR revealed it.

And yet, you want to act like failing to mention that you got twice as many grafts as you told us you got is a minor detail. 🙄

And anyone who reads your opening posts will easily see that your two main gripes were

1. You couldn't get the 300 grafts you expected to get - even though you did get them, but 150 of them went into your donor area. I think most of us could at least understand the disappointment you felt...until you then started saying your hairline wasn't that bad to begin with! WTH? 🤨

2. The areas on the side of your head have been horribly thinned out and look much worse than they did before - which isn't true and they will likely look even better when you give your hair time to recover and grow back in (as everyone has told you).

So your hairline is fine and your sides will be fine...but you're still mad at @BHRClinic. 🤷‍♂️

 

I think that we can seperate 2 things : 

1) complaining about the result of the surgery. 

And as i wrote in this topic, it is way too early to talk about the result. Obvious.

2) planning the surgery and clinic-patient relationship 

Well, here is where the things become weird. 

At initial consultation they talked about around 1000 grafts in the hairline. Patronovski says that BHR didn't inform him about low survival rate (50%). He wrote that this first consultation took place in the clinic. But he didn't mention who examined him.

Then few months later he send to BHR more photos and they said that he will need only 300-400 grafts. 

Then at the day of the surgery they inform him about 50% survival rate and change the plan to 50 test grafts and want to cash him 2000 euro? And then what after this test? He can come later and get rest of the grafts free of charge or have to pay another 2000 euro?

Yeah, to be honest, i don't like this "pay us 2000 euro for the test". Clinic is unsure and wants to do the tests, do it for free or whatever. 

But he was already there, paid for hotel, traveled, wasted his time. So he started bargaining in the heat of the moment. And it ended on 150 grafts in the hairline and "promotional" 150 beard grafts in the donor. I must say that i get why he didn't mention this 150 beard grafts in the donor in his initial post. Because he didn't need it and propably doesn't care about it. Look at his donor before the procedure. It looked fine, this beard transplant in his donor seems useless. 

So to be honest. If at the day of procedure clinic would told me "let's do 50 test grafts for 2000 euro", i think best idea is to walk away. 

3 hours ago, readyforresults said:

Hey there. It was actually on 2,500 grafts. I’m shocked they got so much coverage from that number but here I am. I have been contemplating another round but it’s a lot to consider undergoing that procedure again. 

Wasn't it 3500 grafts? You wrote something like this in one of first posts. It would make more sense because recipient area was pretty big. 

Anyway, the outcome is really good, congratulations 🔥

6 hours ago, Melvin- Admin said:

It will keep saying that, im not removing this until I know this doctor isn’t trying to astroturf. I have to manually approve the posts. If you want them approved sooner, report them. 

@m123456 is posting on polish forum since august 2023, he is real human being in my opinion 😅